Arrhythmias & electrophysiology
In-hospital safety of cryoballoon and radiofrequency ablation in patients with atrial fibrillation—German nationwide analysis of more than 300,000 procedures
Authors' conclusion
RF and CB ablation had low overall procedural complication rates, with CB ablation showing a 50% reduced risk of pericardiocentesis. Centers with higher volume provided a better in-hospital safety with a faster learning curve for CB ablation.
Study context
- Population
- Patients with AF undergoing left atrial catheter ablation in Germany, 2013–2021
- Participants
- 118,984 vs 184,616
- Exposure
- Cryoballoon (CB) ablation vs radiofrequency (RF) ablation
- CBn = 118,984
- RFn = 184,616reference
- Outcome
- Procedural (in-hospital) safety end points
- Follow-up
- In-hospital
Methodological detailsnationwide registry, adjusted for confounders
- Nationwide registry
- Adjusted for confounders
Main finding
As reported in the abstract
In-hospital safety end points
RF
0.08%
In-hospital mortality
CB
0.06%
In-hospital mortality
CB vs RFRelative risk (95% CI)P value
Pericardiocentesis
0.50(0.46–0.55)
P < 0.001Vascular complication
0.36(0.33–0.39)
P < 0.001Ventilation >48 hours
0.81(0.66–0.99)
P = 0.042Observational data: associations, not effects.
Further findings
Pericardiocentesis risk by annual centre procedure volume
- Negative correlation with annual procedures per centre; faster learning curve for CB ablation
- both P < .01
Original publication
In-hospital safety of cryoballoon and radiofrequency ablation in patients with atrial fibrillation—German nationwide analysis of more than 300,000 procedures. Heart Rhythm. Published 13 February 2025. doi:10.
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